Blog

CDI Quick Tips: CDI Synergies with Risk Based and Fee for Service Models

What if you could improve collaboration with physician stakeholders and concurrently bring your inpatient CDI program to the next level? This is possible through the development of an outpatient CDI program that incorporates the physician practice under its umbrella. Physicians are now looking for resources to assist in the implementation of MACRA and MIPS as well and to improve their HCC scores and receive appropriate reimbursement from risk based payers. Those consultations with your physicians related to chronic and secondary diagnoses treated in their professional practice could lead to increased specificity of ICD-10 coding for DRG accuracy and decreased denials in both the outpatient and inpatient setting.

Topics: CDI

CDI Quick Tips: Addressing Outpatient Challenges

In looking toward 2017, hospitals are beginning to seriously consider expanding their CDI program to the outpatient and professional fee world. The increase in patients covered under risk based payment is one reason. The increasing denials due to medical necessity are another. Managing reimbursement in the outpatient setting requires a closer look at the specificity of diagnosis documentation as well as a clear picture of the patient’s diagnostic process, the practitioner’s clinical judgement and the patient’s treatment during the encounter. Let’s look at an example:

Topics: CDI

The eight most important things you should know about the 2016 Commission on Cancer Program Standards Clarifications

Earlier this year, the Commission on Cancer released the 2016 Edition of the Cancer Program Standards: Ensuring Patient-Centered Care. This manual includes clarification and improved language to help further understand how the standards are intended and the criteria for compliance.

Topics: Cancer Registry

Coding Quality Is Priority #1

In 2015, himagine conducted its inaugural HIM Benchmark Survey in the midst of the preparation for ICD-10. At the time, approximately 56% of respondents reported that they planned to outsource at least a portion of their coding. In our 2016 survey, 63% of respondents indicated that they outsource, making it clear that most healthcare providers currently rely on some coding vendor resources and will likely continue to work with outsourced coders going forward.

Topics: Coding, Outsourcing, Quality

2 key questions to optimize coding audits

In our soon to be released second annual HIM Benchmark Report, 70% of HIM leaders indicated they increased auditing efforts in 2016 and a whopping 96% projected to maintain or increase this level of auditing in 2017.

Topics: Coding, Audit, Quality

ICD-10 QUICK TIPS: Proper Episode of Care Coding for Injuries and Cause of Morbidity

Posted by National Compliance and Quality Audit Team on Sep 8, 2016 12:46:08 PM

This week's post comes from National Compliance and Quality Audit Manager, Sharon Nichols, BSBEB, RHIT, CCS, CHTS-TR.

Topics: ICD-10, Coding

AFTER ICD-10, THE CDI WORLD HAS BECOME DATA DRIVEN AND HIGH TECH

Posted by Pamela Hess on Aug 4, 2016 12:11:59 PM

Now that the smoke has cleared from the transition to ICD-10-CM/PCS, the healthcare industry is taking stock of how the transition changed the industry landscape.

Topics: ICD-10, CDI

Russel Head Joins himagine solutions inc. as Chief Operating Officer

Posted by Mike Taylor on Aug 3, 2016 3:56:12 PM

himagine solutions inc., the largest provider of Health Information Management (HIM) outsourcing solutions to healthcare providers in the US, today announced that Russel Head has joined the organization as the new Chief Operating Officer based in Tampa, Florida. In his role Mr. Head will be responsible for all client and revenue generating initiatives including sales and client management, as well as himagine’s industry leading recruiting team.

Topics: HIM, Health Information Management, Healthcare, Management, Corporate

ICD-10 QUICK TIPS: Three Ways to Correctly Code Summer Burns in ICD-10-CM

Posted by National Compliance and Quality Audit Team on Jul 20, 2016 10:10:00 AM

This week's post comes from National Compliance and Quality Audit Manager, Sharon Nichols, BSBEB, RHIT, CCS, CHTS-TR.

Topics: ICD-10, Coding

With the Right Preparation ICD-10 Updates Can Increase Revenue

Posted by Samantha Champagnie on Jul 18, 2016 10:00:34 AM

The next wave of the ICD-10 transition may help Organizations increase revenue through higher level of specificity in claim submission.  The key to this success is driven by continuous monitoring of coding accuracy.

Topics: ICD-10, Coding, Audit